Management of Non-Vital Open Apex in A Lateral Incisor Using Calcium Hydroxide and Reverse GP Cone Cold Lateral Compaction in A General Practice Setting

Author(s):  
Haider Al-Saffar

Although dental trauma is poorly managed by general dental practices, it is important to follow appropriate steps to achieve optimal results. This case report outlines the management of non-vital immature teeth with calcium hydroxide and reverse Gutta Percha (GP) cone cold lateral compaction to achieving endodontic success. Even though it is a disputed technique, if proper conditions are provided, the root development continues to preserve a functionally fit and sound tooth on the arch of a young adolescence, avoiding extensive surgical and prosthetic procedures to replace a potentially compromised tooth. This case report highlights the beneficial effects of both calcium hydroxide and Chlorhexidine-dygluconate (CHX), which are far to be obsolete in the field of apexification or even regenerative dentistry as a whole.The 11 years old male presents post-traumatic necrosis in the upper left lateral incisor (tooth 2.2) which is dressed with calcium hydroxide, achieving the disinfection of the root canal, remission of the apical periodontitis and complete root formation 1 year later. The importance of the use of biocompatible materials as calcium hydroxide and CHX are emphasized in this case in which, although, no modern regenerative procedures and materials were used, the results are more than satisfactory. This report will look into the management of a non-vital immature lateral incisor with a reverse GP cone lateral compaction to achieving a successful apical and canal seal radiographically.

2013 ◽  
Vol 25 (1) ◽  
pp. 42-45
Author(s):  
AFMA Chowdhury ◽  
A Alam ◽  
UK Sarkar ◽  
AA Mahmud ◽  
U Habiba ◽  
...  

Dental trauma is common in young patients with immature teeth. When necrosis of pulp follows in such a tooth, apexification of the root is the most recognized and accepted treatment of choice. Calcium hydroxide paste is the most popular material used to induce the apical hard tissue barrier which may be composed of different tissues. Hertwig’s epithelial root sheath and (or) its remnants, the cell rests of Malassez may contribute to the apical closure. In the presented case, careful multidisciplinary treatment approach helped to regain esthetic and function. After 27 months the tooth showed every sign of success. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.16071 Medicine Today 2013 Vol.25(1): 42-45


2019 ◽  
Vol 9 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Sanjay Prasad Gupta

Anterior spacing is a common esthetic problem of patient during dental consultation. The most common etiology include tooth size and arch length discrepancy. Maxillary lateral incisors vary in form more than any other tooth in the mouth except the third molars. Microdontia is a condition where the teeth are smaller than the normal size. Microdontia of maxillary lateral incisor is called as “peg lateral”, that exhibit converging mesial and distal surfaces of crown forming a cone like shape. A carefully documented diagnosis and treatment plan are essential if the clinician is to apply the most effective approach to address the patient’s needs. A patient sometimes requires a multidisciplinary approach to correct the esthetics and to improve the occlusion. This case report describes the management of an adult female patient with a proclined upper anterior teeth, upper anterior spacing, deep bite and peg shaped upper right lateral incisor tooth through orthodontic and restorative treatment approach.


2008 ◽  
Vol 32 (3) ◽  
pp. 239-242 ◽  
Author(s):  
Robert Anthonappa ◽  
Cynthia Yiu ◽  
Nigel King

Dens evaginatus (DE) and dens invaginatus (DI) are rare developmental dental anomalies affecting both the primary and permanent dentitions. Concurrence of DE and DI within the same tooth is extremely rare. We report a case of DE and DI in a maxillary right lateral incisor tooth. Comprehensive clinical and radiographic examinations are essential to identify such defects; the early diagnosis can then result in the appropriate prophylactic treatment being performed, thus preventing undesirable pulpal complications.


2017 ◽  
Vol 41 (3) ◽  
pp. 187-192
Author(s):  
Atsushi Oishi

This case report describes the importance of continual examination for dental trauma and the efficacy of intentional replantation with retrograde root canal filling for a transverse root fracture in an immature incisor accompanied by subsequent periodontal-endodontic disease. In the treatment of traumatically fractured roots in immature incisors, continual examination is indispensable for the final diagnosis because roots in immature teeth are less calcified, resulting in less detailed radiological examinations. Thus, common dental trauma complications such as pulp necrosis may appear months after the initial examination. Endodontic treatment for transverse root fracture is mainly determined according to radiographic examination findings; for fractured immature roots, apexification with calcium hydroxide of the coronal fragment is generally applied. However, this method requires removal of considerable amounts of enamel and dentin to allow access to the cavity for preparation, which may increase the risk of future fractures. In contrast, intentional replantation with retrograde root canal filling does not require the removal or long-term application of calcium hydroxide. However, it requires careful extraction of the tooth, maintenance of root wetness during the extraoral procedure, rigid splinting, and oral hygiene control. Management of tooth mobility is also important in the post-replantation course.


2013 ◽  
Vol 20 (1) ◽  
pp. 99
Author(s):  
Timothy Soewito ◽  
Darmawan Sutantyo ◽  
Cendrawasih A Farmasyanti

Keberadaan kista dapat menghambat perawatan ortodontik konvensional yang diberikan pada pasien. Tujuan artikel ini adalah menyajikan laporan kasus perawatan ortodontik alternatif seorang pasien perempuan berusia 17 tahun dengan kondisi gigi atas berjejal berat dan kista jinak di antara gigi insisivus lateral dan kaninus kiri atas. Setelah menetapkan diagnosis ortodontik, perawatan pertama yang dilakukan adalah pengangkatan kista. Kista dikirim untuk biopsi dan didiagnosis sebagai kista jinak. Orang tua dan pasien memutuskan untuk mencabut gigi insisivus lateral atas setelah mengetahui bahwa gigi insisivus lateral kiri atas nekrosis. Setelah gigi dicabut, bracket ortodontik dipasang di gigi bawah pasien. Tiga bulan kemudian, bracket ortodontik dipasang di gigi atas pasien. Kondisi gigi atas yang berjejal terkoreksi dan kaninus atas menggantikan posisi insisivus lateral. Saat ini, perawatan aktif masih dilanjutkan dan terpasang bracket ortodontik dengan elastik kelas III pada pasien. Kesimpulan artikel ini adalah pendekatan perawatan ortodontik inkonvensional dapat menjadi pertimbangan ketika ditemukan hambatan seperti adanya kista. Pasien dan orang tua harus diberi informasi mengenai konsekuensi perawatan sebelum perawatan dimulai.Unconventional Orthodontic Treatment for Upper Teeth Crowding with Benign Cyst. The presence of a cyst can provide an obstacle to the conventional orthodontic treatment given to the patients. The purpose of this article is to describe a case report of a seventeen year-old girl with a severe crowding of maxilla and presence of benign cyst between lateral incisor teeth and upper left canine treated with an alternative orthodontic treatment plan. After orthodontic diagnosis, the first treatment to be conducted was the removal of the cyst. The cyst was sent for biopsy and diagnosed as non-malignant cyst. The patient and her parents decided to extract upper laterals incisor tooth after knowing that the upper left lateral incisor tooth was necrotic. After the extractions, orthodontic brackets were bonded on the mandible. Then three months later the maxilla was bonded. The upper crowding of teeth condition was resolved very promptly and the upper canines were used to replace the laterals incisor position. Currently, active treatment is still in progress, and the patient has full upper and lower orthodontic brackets with class III elastics. After the treatment so far, it can be concluded that unconventional orthodontic treatment is worth considering when an obstacle such as a cyst is present. Patients and parents must be informed about the consequences of the treatment before active treatment is started.


2015 ◽  
Vol 5 (1) ◽  
pp. 30-34
Author(s):  
Md Abdul Hannan Sheikha ◽  
Fahd A A Karim ◽  
Asma Sultana ◽  
Tazdik G Chowdhury ◽  
AHM Zakir Hossain Shikder ◽  
...  

This case report describes a case of avulsed left maxillary central incisor tooth which was replanted in the dental office. The tooth was gently rinsed of any debris and placed in normal saline during the examination and preparation of the replantation socket. The tooth was replanted and functionally splinted. The following week the tooth was opened for pulp extirpation and placement of calcium hydroxide. Two weeks later, the root canal was filled with gutta-percha and zinc oxide eugenol sealer, and the access cavity was restored with a bonded composite restoration; the splint was removed. Two year clinical and radiological follow up of the case showed ankylosis and infraocclusion of the replanted toothUpdate Dent. Coll. j: 2015; 5 (1): 30-34


2021 ◽  
Vol 11 (Suppl. 1) ◽  
pp. 285-291
Author(s):  
Meryem Şahin ◽  
İsmet Rezani Totancı

Aim: Traumatic dental injuries at the anterior region of the maxilla occur frequently in children and adults. In this case report, we aimed to describe the temporary aesthetic restoration of the upper lateral incisor with a fiber-reinforced bridge by using the original tooth crown, which had avulsed after dental trauma. Methodology: Case 1: A 14-year-old girl with an avulsion in tooth #11 due to trauma visited our clinic. During the examination, it was seen that the wound had healed, and there was no luxation in teeth #21 and #12. Since the patient could not undergo prosthetic procedures, for reasons including implants, and did not want a removable prosthesis, a single crown supported by acrylic tooth fibers was constructed. Case 2: A 17-year-old male patient was referred to our clinic because of an avulsed left lateral incisor tooth, which was traumatized 15 days before visiting the clinic. His medical history revealed that his parents had found the tooth two hours after the trauma. However, the emergency clinic that he had previously visited did reimplant that tooth and repaired it with fiber-reinforced composite. Case 3: In the examination of a 12-year-old male patient who applied to our clinic due to trauma, it was observed that tooth #11 had an avulsion and tooth #12 had a crown fracture. Root canal treatment was performed. A crown was made for the patient by supporting the fiber inside the canals of tooth #11 and tooth #21. It was revised aesthetically with the support of the crown of the other tooth. Conclusion: Avulsion after anterior trauma affects patients’ appearance aesthetically; thus, patients want to be treated as soon as possible. Function, phonation, and aesthetics must be quickly provided for a loose anterior tooth. Fiber-reinforced adhesive bridge techniques may be considered as a temporary treatment for providing an aesthetically appealing appearance until the completion of permanent prosthetic treatment.   How to cite this article: Şahin M, Toptancı İR. Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports. Int Dent Res 2021;11(Suppl.1):285-91. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.42   Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.


2015 ◽  
Vol 2 (6) ◽  
pp. 505
Author(s):  
MC Noushad ◽  
Mohammed Niyaz ◽  
Faizal C Peedikayil ◽  
CV Pradeep ◽  
Anish Sebastian ◽  
...  

In the past, cases with open apices were often treated over several appointments, using calcium hydroxide, with the hope of creating a ‘‘calcific’’ barrier against which gutta percha could eventually be placed. The treatment could be as long and the prognosis is questionable. These roots were often thinner and, therefore, more brittle; extending treatment over a long period of time without providing a permanent restoration increased the chances of losing these teeth due to fracture. With the favorable histologic response of MTA, this material is the best current choice for this procedure. Completion of these cases in an effective and efficient way allows for permanent restorations to be done in a timelier manner, prolonging the longevity of these teeth. The following case report demonstrates the use of MTA as an obturating material to promote periapical healing with an open apex.


2011 ◽  
Vol 58 (3) ◽  
pp. 168-173
Author(s):  
Mirjana Vujaskovic ◽  
Nikola Stojanovic ◽  
Goran Vujaskovic

Introduction. Knowledge of root canal morphology is one of the main prerequisites for successful endodontic treatment. We present the case of a patient with multiple canals in lower anterior teeth which were treated endodontically. Case Report. To a 45-year-old patient endodontic treatment was applied on lower left lateral incisor, lower right central and lateral incisor and lower right canine. These teeth were previously prepared for prosthetic crowns. All involved teeth had two canals which were not visible on the primary radiographs. Gracility of remaining tooth structure and canals and the presence of two canals in each tooth required additional radiographs for verification of multiple canals. Careful biomechanical instrumentation and irrigation with use of lubrication due to narrow canals was performed. The canals were obturated with gutta-percha using lateral compaction technique and Acroseal (Septodont) paste. On the control checkup after eight months, the patient was asymptomatic, while clinical finding was normal. Conclusion. Complexity of presented case was even more significant because these teeth were prepared to support prosthetic superstructure and crowns, and every ?forgotten? canal is an iatrogenic error.


2021 ◽  
Vol 9 (2) ◽  
pp. 84-87
Author(s):  
Priya Mendiratta ◽  
Pooja Srivastava ◽  
Bhavna Gupta

Management of immature non-vital teeth poses challenge for the clinician owing to the thin root canal walls and open apices which may show apical divergence. Apexification is the technique of inducing the apical closure with a root end filling material for non-vital immature young permanent teeth. Traditionally, Calcium hydroxide was the material of choice for apexification of immature permanent teeth but introduction of MTA has shown remarkable promise as an alternative to calcium hydroxide. This report presents a case of apexification of anterior two young permanent teeth with open apices using MTA and Gutta percha followed by esthetic build up using cast metal posts and full coverage restorations.


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